Please be gentle. (Question on forensic path)

[DoctorFunk]

---

Members don't see this ad.

Hey all,

Just took a test covering autopsy procedures and came across a question in which the professor claims that nonphysicians are the only ones legally allowed to use scalpels in an autopsy. But I have read plenty of sources where dieners are actually the ones who make the first incision.

What is the real protocol in this case? Are there any websites that accurately outline the different roles of dieners and pathologists during an autopsy? Thanks for any help you can offer in advance.

 

[kittykat]

Sorry, I don't understand your question...Dieners are non-physicians.

 

[yaah]

A diener is an autopsy assistant. A physician assistant can be a diener, a resident can be a diener. It's a general term. Autopsies are done in different ways. In general, the hospital will have a professional diener who does all the eviscerations and closes the body up as well as prepares the morgue and cleans up. In some places, the diener's job is limited to just preparing the body and closing up - the physician does more, but that is less common.

Dieners with experience will often harvest all of the organs and make the measurements themselves, leaving the intact organs for the pathologist to dissect.

 

[djmd]

the professor claims that nonphysicians are the only ones legally allowed to use scalpels in an autopsy. But I have read plenty of sources where dieners are actually the ones who make the first incision.

That is what my dieners always tell me.
That is why they chew their way in....

with their incisor teeth...

No, scalpels aren't for doctors only. There might be some stupid state/local law somewhere, but I have never heard of such a thing.

 

[DoctorFunk]

Thanks for the clarification on autopsy procedure. Definitely helped me understand how things are run.

 

[kittykat]

Thanks for the clarification on autopsy procedure. Definitely helped me understand how things are run.

Hey Dr. Funk, you still didn't clarify what your professor was trying to ask.
Yaah gave a perfect description of a diener...here is more if you want:

http://en.wikipedia.org/wiki/Autopsies
http://health.howstuffworks.com/autopsy.htm/printable
http://www.pathguy.com/autopsy.htm

But, i'm curious to know what he was testing you on, the definition or legal statues/codes of criminal procedure. Maybe your post went over my head. Oh well, good luck on your test.

 

[DoctorFunk]

Hey Dr. Funk, you still didn't clarify what your professor was trying to ask.

But, i'm curious to know what he was testing you on, the definition or legal statues/codes of criminal procedure. Maybe your post went over my head. Oh well, good luck on your test.

Here's the question as it appeared on our exam:

Autopsy biosafety considers all autopsies as a potential source of infectious agents. As a result, autopsy suites have instituted practices to reduce the dangers to everyone exposed to an autopsy area. These include all the following, EXCEPT:
A. Delineated PPE (personal protective equipment) for everyone in the autopsy room
B. Neon-lighted warning signs
C. Proper disposal of any human excrement left in the autopsy area
D. Sterile decontamination of the work area and human remains prior to body release
E. Use of scalpels only by licensed physicians

The answer was keyed as option A, which actually was contradicted by our own note packet. Needless to say, almost the entire class is protesting the question, although we are split about 50/50 on whether the false statement is actually B or E. I'd be curious to hear what folks in the field think of the subject!

Again, thanks for all of the helpful information. You guys/gals are great over here!

 

[yaah]

I'm not sure which I would pick. I guess I would want a better definition of what "Delineated PPE" actually is. C-E are definitely not the answers. Option B is weird - I have not idea what that means. A warning sign for what? The only lighted signs we have are the exit signs.

As far as PPE, it could refer to simply gloves, gown, and mask, or alternatively it could be referring to specialized fitted masks and respirators for potential TB exposure cases. I think every morgue has the respirators, but I don't know if they are for everyone in the room or just the people doing the dissection (and then, everyone else in the room would probably not hang around).

I would pick B. Although to be semantical, I am not sure whether we use "sterile decontamination" of the human remains prior to release. We use soap and water and use bleach on the equipment and tables. Is this "sterile decontamination?"

I hate tests sometimes because the answers don't make sense.

 

[Cabbage Head]

I'm not sure which I would pick. I guess I would want a better definition of what "Delineated PPE" actually is. C-E are definitely not the answers. Option B is weird - I have not idea what that means. A warning sign for what? The only lighted signs we have are the exit signs.

As far as PPE, it could refer to simply gloves, gown, and mask, or alternatively it could be referring to specialized fitted masks and respirators for potential TB exposure cases. I think every morgue has the respirators, but I don't know if they are for everyone in the room or just the people doing the dissection (and then, everyone else in the room would probably not hang around).

I would pick B. Although to be semantical, I am not sure whether we use "sterile decontamination" of the human remains prior to release. We use soap and water and use bleach on the equipment and tables. Is this "sterile decontamination?"

I hate tests sometimes because the answers don't make sense.

Wait, our PA's use scalpels for sure. B is ridiculous, but so is E. It's not like everyone in the autopsy suite that uses a scalpel is a physician. You say that C-E are not the answers, but I think E is correct; Limiting scalpel use is NOT a way that infections are controlled.

 

[djmd]

I think the "neon" might refer to the brightly colored Biohazard and MSDS info?

ahhh it is stupid question they should just toss it out.

 

[yaah]

Wait, our PA's use scalpels for sure. B is ridiculous, but so is E. It's not like everyone in the autopsy suite that uses a scalpel is a physician. You say that C-E are not the answers, but I think E is correct; Limiting scalpel use is NOT a way that infections are controlled.

Oh yeah, I was reading the question wrong again - E is definitely the correct answer to the question, because this is NOT a measure that has been instituted by many morgues. Dieners and PAs definitely use scalpels. I hate those ****ing "all of these are true EXCEPT" questions.

 

[Cabbage Head]

Oh yeah, I was reading the question wrong again - E is definitely the correct answer to the question, because this is NOT a measure that has been instituted by many morgues. Dieners and PAs definitely use scalpels. I hate those ****ing "all of these are true EXCEPT" questions.

I thought that's what you meant. Though that's why I thought B was a correct answer, too. Neon signs?